CTOMS UNFILTERED

The Best One Handed Bandage…Wait, What?

I’ve been asked “what is the best one-handed bandage?” or variations thereof, and I even see discussions about it online. Apparently there are even people instructing the importance of a one-handed bandage on courses that others pay money to take. Here’s my opinion on the matter.

Fact: Tourniquets are contextually safe and save lives. That data is plentiful and widely available, so there are no excuses left to poo poo tourniquets.

Fact: Wound packing will effectively stop life threatening hemorrhage if performed correctly. We don’t coat bandages with hemostatic compounds, we make then into gauze that can be packed into wounds instead, so we can get to where the actual bleeding is and work to effectively plug the leak. Even if you only have regular gauze…even if you only have a dirty T-shirt, for a penetrating wound with associated arterial bleeding, pack it deep and tight and hold the pressure. That is effective hemorrhage control.

Now bandages on the other hand. I’ve never heard of a bandage to ‘save a life’. Bandages by themselves are used to threat non-life threatening hemorrhage, or to hold gauze in place and provide pressure on a packed wound. Remember, a bandage is not a tourniquet. The force applied wrapping a bandage tightly is not enough to stop arterial blood flow. It is intended for non-life threatening venous bleeding. In reality, it may actually stop all venous flow, but still allow arterial flow causing a compartment syndrome and if there is a wound distal to the tightly wrapped bandage on the arm, cause even worse bleeding! Blood goes past the wrapped bandage at high arterial pressure, but can’t get back into the core under the low venous pressure. Nowhere to go but out the wound and or backup into the cells.

So here’s the punchline you’ve all been waiting for. That damn logic:

If you have life threatening hemorrhage to your arm (hence why you need to apply treatment one handed) then apply a tourniquet because a bandage will not stop life threatening hemorrhage!

And if it’s non-life threatening bleeding, then don’t waste a perfectly good bandage! But seriously, then brace it against the floor, door, wall, wrap it up and carry on camping. So the bottom line “what is the best one-handed bandage?”. Who care’s! Stop making this difficult.

Now I want to hear the other side of the this debate from you. If you disagree, please post a comment.

Disclaimer: The views and opinions expressed herein are those of the author and the voices in his head and are not necessarily those of CTOMS or necessarily necessary at all.